Provider Demographics
NPI:1578775367
Name:HAFFER, ANDREW STEPHEN THEODORE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:STEPHEN THEODORE
Last Name:HAFFER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4223 RIVERSEDGE WAY
Mailing Address - Street 2:
Mailing Address - City:DUNDALK
Mailing Address - State:MD
Mailing Address - Zip Code:21222
Mailing Address - Country:US
Mailing Address - Phone:410-477-3428
Mailing Address - Fax:
Practice Address - Street 1:10903 NEW HAMPSHIRE AVENUE, BLDG #22
Practice Address - Street 2:RM 1237
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20993
Practice Address - Country:US
Practice Address - Phone:301-796-2268
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD14225183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist